Dysphagia which is more for liquids than for solids in a 25-year-old female strongly suggests the possibility of

.ACHALASIA CARDIA is a failure of relaxation of cardia (oesophagogastric junction) due to disorganised oesophageal peristalsis, as a result of a failure of integration of parasympathetic impulses causing functional obstruction.Aetiology comprises of, * There is absence or less numbered ganglions in myenteric plexus. - Stress. - Vit B1 deficiency. - Chaga's disease. - Diffuse oesophageal spasm (Cork-screw oesophagus). Common in females between 20 and 40 years age group. * Chest pain occurs in an early stage. * Achalasia with diffuse oesophageal spasm is called as 'vigorous achalasia'. * Presents with progressive dysphagia, which is more for liquid than to solid food. * Regurgitation and recurrent pneumonia are common (10%). * Malnutrition and general ill health. * Lung abscess formation. * Odynophagia and weight loss.Barium swallow is diagnostic (bird beak appearance ) Ref: SRB&;s manual of surgery,3 rd ed, pg no 745